| Depending
on which health plan you have, you may end up paying your medical
bills instead of your insurance paying. It's important to research
all of your options, not only your plan options but your access
to providers on the plan as well.
The following
are descriptions of different types of health plans. Your employer
may offer one or more. Check with your employer to see what options
are available to you.
Indemnity
Plans
are also know as traditional or fee-for-service plans. They allow
you to choose any doctor and hospital you want, and you pay an annual
deductible and a percentage of your medical bills. While this plan
offers the greatest freedom to choose a provider, Indemnity Plans
are often the most expensive option.
Preferred Provider Organizations
or PPO’s allow
you to choose from doctors who belong to the PPO network. You can
also visit non-network physicians for an additional fee. In most
cases, you can seek care when needed without having permission from
the plan first. Keep in mind that with a PPO, it’s cheaper to visit
“preferred providers,” but you still receive coverage when
visiting an out-of-network doctor.
Health
Maintenance Organizations or HMO’s
require a set co-payment when
you visit an HMO doctor. In most cases, you will not be required to
pay a deductible. With an HMO, you select a primary care physician
to manage all of your health care needs including referring you to
any needed specialists. Generally, there is no coverage for visits
to a provider not in the HMO which means you are required to pay the
full medical bill (except for emergencies).
Point
of Service Plans or POS’s
are also know as Access HMO’s because they add the benefit of out-of-network
physicians. Like an HMO, you select a primary care physician who
is responsible for overseeing all your medical needs, including
referrals to specialists. The difference with a POS is you may have
the option of seeing an out-of-network doctor, for additional costs.
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